Motivation for alcohol consumption or abstinence during pregnancy: A clinical-qualitative study in Brazil

BACKGROUND: In Brazil, alcohol consumption is estimated to range from 7 to 40% in pregnant women. This research investigated the motivation for alcohol consumption or abstinence during pregnancy in a purposive sample of Brazilian women. METHODS: Clinical-qualitative research was conducted, in which 14 women participated, identified as risk-drinkers during pregnancy by the T-ACE screening tool. Data were collected through semi-structured individual interviews. Reports were recorded, transcribed and investigated by a thematic content analysis approach. The results were discussed based on a comprehensive and interpretive framework. RESULTS: Sixteen themes were extracted and these were then classified into three thematic categories: (a) general motives for alcohol use, (b) specific motives for drinking during pregnancy, and (c) reasons for partly or fully abstaining from drinking during pregnancy. Social motives were the most relevant, particularly due to deeply rooted cultural values. Enhancement motives were widely mentioned and associated with a hedonic posture. Consumption also aimed to deal with negative emotions, characterizing two types of coping specifically to pregnancy: first, perceiving pregnancy as a period of less opportunity for social interaction and, therefore, drinking alcohol at home to compensate; secondly, perceiving pregnancy as a period of greater irritability, and hence experiencing difficulties to abstain. On the other hand, concern about fetal health, disapproval of consumption by relatives and health professionals, as well as the social construction of mothering were reported as reasons to abstain. CONCLUSIONS: Some specificities influence the decision to continue or discontinue alcohol consumption during pregnancy. To reduce consumption, we suggest educational actions based on a collective health perspective, articulated with individualized measures that allow identification and proper intervention for women at risk.